Bioethics experts played a key role in ensuring a coherent ethical response to the COVID-19 pandemic in the fields of healthcare, public health, and scientific research in Canada. In the province of Quebec, a group of academic and practicing bioethicists met periodically in the early months of the pandemic to discuss approaches and solutions to ethical dilemmas encountered during the crisis. These meetings created the opportunity for a national survey of bioethics practitioners from different fields. (...) The survey, in which forty-five Canadian bioethics practitioners (clinical ethicists, ethicist members of REBs and government health policy ethicists, or any bioethicist practicing outside of academia) participated, explored their concerns, challenges and opportunities during the first wave of the pandemic, with the objective of informing bioethics research about the difficulties experienced by bioethicists “in the field”. Participants reported increased stress levels, increased workloads, and a greater proportion of their work being devoted to public health ethics. Most of their concerns focused on groups other than themselves, such as health professionals, patients, research participants, and people in vulnerable socio-economic situations. An optimism about the future of bioethics was noted due to an increased awareness of the importance of bioethics by the public and by health and research institutions. (shrink)

Technological developments involving robotics and artificial intelligence devices are being employed evermore in elderly care and the healthcare sector more generally, raising ethical issues and practical questions warranting closer considerations of what we mean by “care” and, subsequently, how to design such software coherently with the chosen definition. This paper starts by critically examining the existing approaches to the ethical design of care robots provided by Aimee van Wynsberghe, who relies on the work on the ethics of care by (...) Joan Tronto. In doing so, it suggests an alternative to their non-principled approach, an alternative suited to tackling some of the issues raised by Tronto and van Wynsberghe, while allowing for the inclusion of two orientative principles. Our proposal centres on the principles of autonomy and vulnerability, whose joint adoption we deem able to constitute an original revision of a bottom-up approach in care ethics. Conclusively, the ethical framework introduced here integrates more traditional approaches in care ethics in view of enhancing the debate regarding the ethical design of care robots under a new lens. (shrink)

The COVID-19 pandemic has coincided with the proliferation of ethical guidance documents to assist public health authorities, health care providers, practitioners and staff with responding to ethical challenges posed by the pandemic. Like ethical guidelines relating to infectious disease that have preceded them, what unites many COVID-19 guidance documents is their dependency on an under-developed approach to bioethical principlism, a normative framework that attempts to guide actions based on a list of prima facie, unranked ethical principles. By situating (...) them in relation to the key philosophical debates concerning bioethical principlism, we aim to explore the limits and limitations of pandemic ethical guidance documents as, specifically, ethics documents – documents that fulfil the functions of ethics as a fundamentally normative discipline. This means not only determining whether such ethical guidance documents can, in principle, provide adequate action guidance and action justification, but also, more importantly where pandemics are concerned, determining whether they support consistent decision making and transparent processes of justification. Having highlighted the problems with merely furnishing ethical guidelines with substantive ethical content in terms of principles and values, we argue that organizations that develop these documents should, instead, focus on the procedural dimensions of action guidance and action justification, which extend to questions regarding the make-up of the committees, panels and groups that develop such guidelines, the public transparency of justifications for specific pandemic-related advice or interventions and the development of explicit procedures for transparent and consistent decision making. (shrink)

Education on authorship was delivered and evaluated by pre test and post test questionnairen on 30 post graduate medical students at the Department of Anestheology, Dhaka Medical College, Bangladesh between January and June 2019 to understand the knowledge, skill and attitude of post graduate medical students on authorship. Result: Before intervention, majority (60%) of the students felt that who perform the research work should be the author of the article. But 40% students were divided and felt that who advised the (...) design of the research (20%), who provided the grants (10%) and Chief/Head of the division (10%) should be the author of the article respectively. Maximum (70%) respondents did not know the order of authorship. Of 40% respondent felt that the PI should be always the first author and 40% don’t know the answer. Half of the students (50%) felt that keeping honorary author increased the opportunity of acceptance of publication. Of 36.7% and 13.3% of students felt that keeping honorary author increased the article’s value and made good relation to them to get some extra facility from them respectively. Of 20% participants were pressurized by lab head/head of department for inclusion of their name as an author. Half of the (56.7 %) respondents felt that the author’s contribution should be stated in the article. Only few 4 (13.3%) respondents said that their institute had guideline for authorship. However, after education 100% of students felt that who perform the research work should be only the author of the article. All (100%) respondents understood the order of authorship. Most of the students (86%) felt that PI should be always the first author. Of 100% respondent felt supervisor of the research should be the last author. All students (100%) felt author’s contribution should be mentioned in the article. All (100%) students did not want to include as author those who help in research design and secured grant; and they did not like to keep honorary author in their article. All (100%) students expressed that their institute had no guideline for authorship. After intervention, three groups of students were asked to write one page of article on Anesthesiology. Interestingly, they did not include any name in the author by line who were not participate or had any contribution in the writing. Conclusion: The comparative data between pre- and post-text have highlighted a general lack of understanding of the basic concept of authorship ethics which significantly improved after the intervention. The results also indicate that the education on authorship improved the awareness of postgraduate medical students in a particular centre. (shrink)

Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an Ethics Framework for Big Data in Health and Research developed by a working group convened by the (...) Science, Health and Policy-relevant Ethics in Singapore Initiative. It presents the aim and rationale for this framework supported by the underlying ethical concerns that relate to all health and research contexts. It also describes a set of substantive and procedural values that can be weighed up in addressing these concerns, and a step-by-step process for identifying, considering, and resolving the ethical issues arising from big data uses in health and research. This Framework is subsequently applied in the papers published in this Special Issue. These papers each address one of six domains where big data is currently employed: openness in big data and data repositories, precision medicine and big data, real-world data to generate evidence about healthcare interventions, AI-assisted decision-making in healthcare, public-private partnerships in healthcare and research, and cross-sectoral big data. (shrink)

Responsive governance during the COVID-19 pandemic became a severe challenge for countries worldwide. With a relatively poor healthcare structure, Bangladesh performed moderately well in managing the first wave of the pandemic (March-December 2020). With substantive policy and decision-making support from the Centre, local governments collaborated with various relevant actors to enhance their pandemic-related services. In this background, this research used an integrative framework to study a case of local-level collaborative governance-the Saturia Model. Based on the authors' (...) experience, reflections and review, this analysis explores various socioeconomic and environmental factors behind the effectiveness of this collaboration in containment policies and providing support services to vulnerable groups. Findings indicate that coordination between state and non-state actors, resource mobilization, access and communication, community engagement and the adaptative capacity of the government are vital for making such collaborations work in a crisis. The lessons are valuable for prospective understanding and policy interventions. (shrink)

Given the unprecedented novel nature and scale of coronavirus and the global nature of this public health crisis, which upended many public/environmental research norms almost overnight. However, with further waves of the virus expected and more pandemics anticipated. The COVID-19 pandemic of 2020 opened our eyes to the ever-changing conditions and uncertainty that exists in our world today, particularly with regards to environmental and public health practices disruption. This paper explores environmental and public health evidence-based practices toward responding to (...) Covid-19. A literature review tried to do a deep dive through the use of various search engines such as Mendeley, Research Gate, CAB Abstract, Google Scholar, Summon, PubMed, Scopus, Hinari, Dimension, OARE Abstract, SSRN, Academia search strategy toward retrieving research publications, “gray literature” as well as reports from expert working groups. To achieve enhanced population health, it is recommended to adopt widespread evidence-based strategies, particularly in this uncertain time. As only together can evidence-informed decision-making (EIDM) can become a reality which include effective policies and practices, transparency and accountability of decisions, and equity outcomes; these are all more relevant in resource-constrained contexts, such as Nigeria. Effective and ethical EIDM though requires the production as well as use of high-quality evidence that are timely, appropriate and structured. One way to do so is through co-production. Co-production (or co-creation or co-design) of environmental/public health evidence considered as a key tool for addressing complex global crises such as the high risk of severe COVID-19 in different nations. A significant evidence-based component of environmental/public health (EBEPH) consist of decisions making based on best accessible, evidence that is peer-reviewed; using data as well as systematic information systems; community engagement in policy-making; conducting sound evaluation; do a thorough program-planning frameworks; as well as disseminating what is being learned. As researchers, scientists, statisticians, journal editors, practitioners, as well as decision makers strive to improve population health, having a natural tendency toward scrutinizing the scientific literature aimed at novel research findings serving as the foundation for intervention as well as prevention programs. The main inspiration behind conducting research ought to be toward stimulating and collaborating appropriately on public/environmental health action. Hence, there is need for a “Plan B” of effective behavioral, environmental, social as well as systems interventions (BESSI) toward reducing transmission. (shrink)

Most people who defend physician-assisted death (PAD) endorse the Joint View, which holds that two conditions—autonomy and welfare—must be satisfied for PAD to be justified. In this paper, we defend an Autonomy Only view. We argue that the welfare condition is either otiose on the most plausible account of the autonomy condition, or else is implausibly restrictive, particularly once we account for the broad range of reasons patients cite for desiring PAD, such as “tired of life” cases. Moreover, many (...) of the common objections to an Autonomy Only view fail once we understand the extent of the autonomy condition’s requirements—in particular, the importance of one’s values for autonomous choices. If our view is correct, then the scope of permissible PAD is broader than is currently accepted in both the philosophical literature and the law, and therefore poses an important challenge to this widely accepted view on justified PAD. (shrink)

In this article, I critically reassess Iris Marion Young's late works, which centre on the distinction between liability and social connection responsibility. I concur with Young's diagnosis that structural injustices call for a new conception of responsibility, but I reject several core assumptions that underpin her distinction between two models and argue for a different way of conceptualising responsibility to address structural injustices. I show that Young's categorical separation of guilt and responsibility is not supported by the writings of (...) Hannah Arendt, which Young draws on, and that it is also untenable on independent systematic grounds. Furthermore, I argue that several of Young's other criteria fail to clearly demarcate two distinct phenomena. I therefore propose to transcend Young's distinction between two models in favour of a related, but conceptually different distinction between two forms of responsibility: interactional and structural. Embracing this terminology facilitates the conceptualisation of the general features of responsibility that are shared by both forms, including their retrospective and prospective time-direction and their applicability to individual, joint and group agency. The distinction between interactional and structural responsibility also yields a more compelling general account of the role of background structures, and of blame within ascriptions of political responsibility. (shrink)

This paper uses the figure of the nomad from the work of Rosi Braidoti to critically examine rhetoric about vaccine and masking mandates, and the science of covid more broadly. I draw out the tensions and ambivalence felt as we navigate this on-going crisis in ways epitomized by the phrase “I have a healthy mistrust of authority, and I am still vaccinated.” Though ambivalent, the nomadic subject finds an affirmative ethics, navigating the “right” response to incite positive change and (...) expose our current states of subjectivity. Recognizing the ambivalence of this state may be useful for feminists who critique medicine for its historical sexist and racist “objectivism,” while also supporting medical science and trust in the case of vaccine mandates. (shrink)

In human-centred design (HCD), researchers and designers develop products in cooperation with the potential users of these products. They attempt to give users a voice or a role in their projects, with the intention of developing products that match users’ needs and preferences. This approach is especially interesting in the information and communication technology (ICT) industry, in which many innovations are driven by development of technologies. The author works in HCD projects in the ICT industry and studied one particular project (...) as a participant observer. In this project, two telecom applications were designed together with and for two groups of users: police officers and people who provide informal care. The resulting case studies are interpreted, drawing from the fields of design studies and science and technology studies, and using texts of the philosophers Levinas and Derrida. HCD is presented as a process that happens between people and as a process with ethical qualities. The case studies demonstrate that HCD is a worthwhile approach. They also show the difficulties of cooperating with users and of multi-disciplinary team-work. HCD practitioners attempt to be open towards others, but they also tend to move towards closure and towards the self. The author suggests reflexive practice as a way for practitioners to be more aware of and to articulate these tendencies. This is intended to help them to better align their practices with what HCD can be about: a process of learning and creating together. (shrink)

The ongoing global pandemic of Covid-19 has exposed SARS-CoV-2 as a potent non-human actant that resists the joint scientific, public health and socio-political efforts to contain and understand both the virus and the illness. Yet, such a narrative appears to conceal more than it reveals. The seeming agentiality of the novel coronavirus is itself but one manifestation of the continuous destruction of biodiversity, climate change, socio-economic inequalities, neocolonialism, overconsumption and the anthropogenic degradation of nature. Furthermore, focusing on the (...) virus – an entity that holds an ambiguous status between the ‘living’ and ‘non-living’ – brings into question the issue of the agentiality of non/living matter. While the story of viral potency seems to get centre stage, overshadowing the complex and perverse entanglement of processes and phenomena which activated these potentials in the first place, the Covid-19 pandemic also becomes a prism that sheds light on the issues of environmental violence; social and environmental injustices; more-than-human agentiality; and ethico-political responses that the present situation may mobilise. -/- This article serves as a written record of joint conversations between artists and researchers in the working group ‘Non/Living Queerings’ that formed part of the online series of events ‘Braiding Friction’ organised by the research project Biofriction. The article strives to capture the collective effort of braiding and weaving a variety of situated perspectives, theoretical toolboxes, knowledges and experiences against the background of the ongoing Covid-19 pandemic. In particular, the text focuses on the issues of crisis, ‘amplification effect’, viral agency and the changing notions of humanity. (shrink)

In various responses to the COVID-19 pandemic, we can observe insufficient sensitivity towards the needs and circumstances of poorer citizens. Particularly in a context of high inequality, policy makers need to engage with the wider public in debates and consultations to gain better insights in the realities of the worst-off within their jurisdiction. When consultations involve members of traditionally underrepresented groups, these are not only more inclusive, which is in itself an ethical aim, but pool ideas and observations from (...) a much more diverse array of inhabitants. Inclusivity increases the odds to identify a larger range of weak spots for health security and to design health interventions that are less burdensome on those worst-off. (shrink)

The EDPS Ethics Advisory Group (EAG) has carried out its work against the backdrop of two significant social-political moments: a growing interest in ethical issues, both in the public and in the private spheres and the imminent entry into force of the General Data Protection Regulation (GDPR) in May 2018. For some, this may nourish a perception that the work of the EAG represents a challenge to data protection professionals, particularly to lawyers in the field, as well as (...) to companies struggling to adapt their processes and routines to the requirements of the GDPR. What is the purpose of a report on digital ethics, if the GDPR already provides all regulatory requirements to protect European citizens with regard to the processing of their personal data? Does the existence of this EAG mean that a new normative ethics of data protection will be expected to fill regulatory gaps in data protection law with more flexible, and thus less easily enforceable ethical rules? Does the work of the EAG signal a weakening of the foundation of legal doctrine, such as the rule of law, the theory of justice, or the fundamental values supporting human rights, and a strengthening of a more cultural approach to data protection? Not at all. The reflections of the EAG contained in this report are not intended as the continuation of policy by other means. It neither supersedes nor supplements the law or the work of legal practitioners. Its aims and means are different. On the one hand, the report seeks to map and analyse current and future paradigm shifts which are characterised by a general shift from analogue experience of human life to a digital one. On the other hand, and in light of this shift, it seeks to re-evaluate our understanding of the fundamental values most crucial to the well-being of people, those taken for granted in a data-driven society and those most at risk. The objective of this report is thus not to generate definitive answers, nor to articulate new norms for present and future digital societies but to identify and describe the most crucial questions for the urgent conversation to come. This requires a conversation between legislators and data protection experts, but also society at large - because the issues identified in this report concern us all, not only as citizens but also as individuals. They concern us in our daily lives, whether at home or at work and there isn’t a place we could travel to where they would cease to concern us as members of the human species. (shrink)

This commentary further explores some of the ethical issues raised by Prof. Peter Singer in his Lanson Lecture “Pandemic Ethics: Five Lessons”. In the first part, I distinguish a prioritarian approach to the allocation of scarce medical resources, from the utilitarian one advocated by Singer. I suggest that the prioritarian view better matches common intuitions about fair distribution, even though it likely needs to be balanced with other principles if it is to have plausibility in contexts like vaccine (...) allocation. In the second part of the commentary, I take a global perspective (as Singer himself does regarding the ethics of lockdowns), and highlight the controversial implications of adopting a fully cosmopolitan ethical outlook when deciding how to distribute Covid-19 vaccines. I also raise justice-related concerns about Singer’s proposal to use well-being as a single metric for evaluating public health policies. (shrink)

The Global Forum on Bioethics in Research (GFBR) served as a global platform for debate on ethical issues in international health research between 1999 and 2008, bringing together research ethics experts, researchers, policy makers and community members from developing and developed countries. In total, nine GFBR meetings were held on six continents. Work is currently underway to revive the GFBR. This paper describes the purpose and history of the GFBR and presents key elements for its reinstatement, future functioning (...) and sustainability. Potential participants and sponsors are encouraged to contribute actively to the future of this unique international research ethics event. (shrink)

In many countries, the COVID‐19 pandemic varied starkly between different racial and ethnic groups. Before vaccines were approved, some considered assigning priority access to worse‐hit racial groups. That debate can inform rationing in future pandemics and in some of the many areas outside COVID‐19 that admit of racial health disparities. However, concerns were raised that “race‐responsive” prioritizations would be ruled unlawful for allegedly constituting wrongful discrimination. This legal argument relies on an understanding of discrimination law as demanding color‐blindness. We (...) argue that a, color‐blind understanding of discrimination would be hostile only to one of two rationales for prioritizing the relevant racial minorities in settings of racial health disparities. We also propose a method for incorporating appropriate race‐responsive concerns that is in many ways ethically and legally superior to ones suggested thus far. That method turns artificial intelligence, thanks precisely to its artificial and “black box” nature (features that underlie recent concerns about artificial intelligence's discriminatory potential), into an instrument of social justice. (shrink)

When parties and interest groups interact, they can do so in several ways which could be on an informal level, lobbying for a party candidate, or group representatives approach party leaders in the parliament to lobby them on an issue. There is a plethora of studies on the extent to which major political parties and major interests have related in the past and continue to relate or interact at the organizational level. Researchers have investigated to what extent parties and (...) groups had formal organizational ties, cooperated in elections, or worked in concert on developing and implementing policies. Factors that for decades have determined the relationship between political parties and interest groups in liberal democracies are political system and subsystem development, political culture and political ideology, centralization of government and policymaking, nature of the party system, political party dependence on interest groups, encompassing characteristics of the interest group system, interest group development, ideology, and leadership. However, the pandemic has influenced to a great extend the relationship between interest groups and politics. While Covid-19 crisis has consolidated power within governments, leaving opposition parties in a bind, on the other hand it has galvanized interest groups and businesses to mobilize. The pandemic has opened up the lobbying playing field to many new players. The paper aims to investigate to what extend the pandemic has influenced the relationship between political parties, government and interest groups and what strategies have these last ones used to get heard in a time when social distancing has reduced the opportunities for face-to-face lobbying. (shrink)

The pandemic significantly raised the stakes for the translation of bioethics insights into policy. The novelty, range and sheer quantity of the ethical problems that needed to be addressed urgently within public policy were unprecedented and required high‐bandwidth two‐way transfer of insights between academic bioethics and policy. Countries such as the United Kingdom, which do not have a National Ethics Committee, faced particular challenges in how to facilitate this. This paper takes as a case study the (...) brief career of the Ethics Advisory Board (EAB) for the NHS Covid‐19 App, which shows both the difficulty and the political complexity of policy‐relevant bioethics in a pandemic and how this was exacerbated by the transience and informality of the structures through which ethics advice was delivered. It analyses how and why, after EAB's demise, the Westminster government increasingly sought to either take its ethics advice in private or to evade ethical scrutiny of its policies altogether. In reflecting on EAB, and these later ethics advice contexts, the article provides a novel framework for analysing ethics advice within democracies, defining four idealised stances: the pure ethicist, the advocate, the ethics arbiter and the critical friend. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

In response to the COVID‐19 pandemic philosophers and governments have proposed scarce resource allocation guidelines. Their purpose is to advise healthcare professionals on how to ethically allocate scarce medical resources. One challenging feature of the pandemic has been the large numbers of patients needing mechanical ventilatory support. Guidelines have paradigmatically focused on the question of what doctors should do if they have fewer ventilators than patients who need respiratory support: which patient should get the ventilator? There is, however, (...) an important higher level allocation problem. Namely, how are we to ethically distribute newly obtained ventilators across hospitals: which hospital should get the ventilator(s)? In this paper, we identify a set of principles for allocating newly obtained ventilators across hospitals. We focus particularly on low and middle income countries, who frequently have limited pre‐existing intensive care capacity, and have needed to source additional ventilators. We first provide some background. Second, we argue that the main population healthcare aim during the COVID‐19 pandemic should be to save the most lives. Next, we assess a series of potential heuristics or principles that could be used to guide allocation: allocation to the most densely populated cities, random allocation, allocation based on the ratio of patients to ICU personnel, prioritisation in terms of intrahospital mortality, prioritisation of younger populations, and prioritisation in terms of population mortality. We conclude by providing a plausible ranking of the principles, while noting a number of epistemological challenges, in terms of how they best further the aim of increasing the probability of saving the most lives. (shrink)

The purpose of this essay is to make the case that the ethical issues raised by the current U.S. practice of direct-to-consumer prescription drug advertising are worthy of study in philosophy courses, and to provide instructors with some ideas for how they might approach teaching the topic, despite the current relative scarcity of philosophical literature published on it. This topic presents a unique opportunity to cover ground in ethics, critical thinking, and scientific literacy simultaneously. As a case study, the (...) practice of DTC advertising is both theoretically rich and universally relevant to students’ lives. The nature of these ads—numerous, diverse, visually and thematically entertaining—makes them delicious fodder for in-class activities, small group work, discussion-based learning, creative projects, and customizable essay topics. I offer a set of suggestions for approaching the study of DTC drug ads that is informed by my own experience doing so in bioethics courses. Ultimately, including this topic on your syllabus not only contributes to students’ philosophical skills and knowledge, but also helps them become better informed as citizens and potential “consumers” of health care. (shrink)

We raise the following problem for so-called target-centred virtue ethics. An important motivation for adopting target-centred virtue ethics over other forms of virtue ethics is its supposedly distinctive account of right action: an action is right if and only if and because it is virtuous, and what makes an action virtuous is that it hits the target of the virtues. We argue that the account is not distinctive of target-centred virtue ethics, because it is an account (...) that is widely endorsed by Neo-Aristotelians. Hence, the argument of this paper undermines a central motivation for adopting target-centred virtue ethics. As a solution, we suggest that there is theoretical room for a target-centred account that is not Neo-Aristotelian, and we draw on the work of Confucian philosopher Wáng Yángmíng to provide one. We defend the resulting account by arguing that it has the advantage of being able to offer us a more plausible response to the self-centredness objection that has long been a problem for Neo-Aristotelians. (shrink)

A crucial socio-political challenge for our age is how to rede!ne or extend group membership in such a way that it adequately responds to phenomena related to globalization like the prevalence of migration, the transformation of family and social networks, and changes in the position of the nation state. Two centuries ago Immanuel Kant assumed that international connectedness between humans would inevitably lead to the realization of world citizen rights. Nonetheless, globalization does not just foster cosmopolitanism but simultaneously yields (...) the development of new group boundaries. Group membership is indeed a fundamental issue in political processes, for: “the primary good that we distribute to one another is membership in some human community” – it is within the political community that power is being shared and, if possible, held back from non-members. In sum, it is appropriate to consider group membership a fundamental ingredient of politics and political theory. How group boundaries are drawn is then of only secondary importance. Indeed, Schmitt famously declared that “[e]very religious, moral, economic, ethical, or other antithesis transforms into a political one if it is suffciently strong to group human beings e#ectively according to friend and enemy”. Even though Schmitt’s idea of politics as being constituted by such antithetical groupings is debatable, it is plausible to consider politics among other things as a way of handling intergroup di#erences. Obviously, some of the group-constituting factors are more easily discernable from one’s appearance than others, like race, ethnicity, or gender. As a result, factors like skin color or sexual orientation sometimes carry much political weight even though individuals would rather con!ne these to their private lives and individual identity. Given the potential tension between the political reality of particular groupmembership defnitions and the – individual and political – struggles against those definitions and corresponding attitudes, citizenship and civic behavior becomes a complex issue. As Kymlicka points out, it implies for citizens an additional obligation to non-discrimination regarding those groups: “[t]his extension of non-discrimination from government to civil society is not just a shift in the scale of liberal norms, it also involves a radical extension in the obligations of liberal citizenship”. Unfortunately, empirical research suggests that political intolerance towards other groups “may be the more natural and ‘easy’ position to hold”. Indeed, since development of a virtue of civility or decency regarding other groups is not easy, as it often runs against deeply engrained stereotypes and prejudices, political care for matters like education is justified. Separate schools, for example, may erode children’s motivation to act as citizens, erode their capacity for it and!nally diminish their opportunities to experience transcending their particular group membership and behave as decent citizens. This chapter outlines a possible explanation for such consequences. That explanation will be found to be interdisciplinary in nature, combining insights from political theory and cognitive neuroscience. In doing so, it does not focus on collective action, even though that is a usual focus for political studies. For example, results pertaining to collective political action have demonstrated that the relation between attitudes and overt voting behavior or political participation is not as direct and strong as was hoped for. Several conditions, including the individual’s experiences, self-interest, and relevant social norms, turned out to interfere in the link between his or her attitude and behavior. Important as collective action is, this chapter is concerned with direct interaction between agents and the in$uence of group membership on such interaction – in particular joint action. Although politics does include many forms of action that require no such physical interaction, such physical interaction between individuals remains fundamental to politics – this is the reason why separate schooling may eventually undermine the citizenship of its isolated pupils. This chapter will focus on joint action, de!ned as: “any form of social interaction whereby two or more individuals coordinate their actions in space and time to bring about a change in the environment”. Cognitive neuroscienti!c evidence demonstrates that for such joint action to succeed, the agents have to integrate the actions and expected actions of the other person in their own action plans at several levels of speci!city. Although neuroscienti!c research is necessarily limited to simple forms of action, this concurs with a philosophical analysis of joint action, which I will discuss below. (shrink)

COVID-19 demonstrated a global catastrophe that touched everybody, including the scientific community. As we respond and recover rapidly from this pandemic, there is an opportunity to guarantee that the fabric of our society includes sustainability, fairness, and care. However, approaches to environmental health attempt to decrease the population burden of COVID-19, toward saving patients from becoming ill along with preserving the allocation of clinical resources and public safety standards. This paper explores environmental and public health evidence-based practices toward responding (...) to Covid-19. A literature review tried to do a deep dive through the use of various search engines such as Mendeley, Research Gate, CAB Abstract, Google Scholar, Summon, PubMed, Scopus, Hinari, Dimension, OARE Abstract, SSRN, Academia search strategy toward reretrieving research publications, “grey literature” as well as reports from expert working groups. To achieve enhanced population health, it is recommended to adopt widespread evidence-based strategies, particularly in this uncertain time. As only together can evidence-informed decision-making (EIDM) can become a reality which includes effective policies and practices, transparency and accountability of decisions, and equity outcomes; these are all more relevant in resource-constrained contexts, such as Nigeria. Effective and ethical EIDM though requires the production as well as use of high-quality evidence that are timely, appropriate and structured. One way to do so is through co-production. Co-production (or co-creation or co-design) of environmental/public health evidence considered as a key tool for addressing complex global crises such as the high risk of severe COVID-19 in different nations. A significant evidence-based component of environmental/public health (EBEPH) consist of decisions making based on best accessible, evidence that is peer-reviewed; using data as well as systematic information systems; community engagement in policy making; conducting sound evaluation; do thorough program-planning frameworks; as well as disseminating what is being learned. As researchers, scientists, statisticians, journal editors, practitioners, as well as decision-makers strive to improve population health, having a natural tendency toward scrutinizing the scientific literature aimed at novel research findings serving as the foundation for intervention as well as prevention programs. The main inspiration behind conducting research ought to be toward stimulating and collaborating appropriately on public/environmental health action. Hence, there is need for a “Plan B” of effective behavioural, environmental, social as well as systems interventions (BESSI) toward reducing transmission. (shrink)

Source: Author: Agnes F. Montalbo The aim of this study was to measure the exhaustion, cynicism and professional efficacy that would determine an individual’s level of burnout. A convenient sample of employees was obtained from different call centers in Metro Manila. The results indicated a high level of exhaustion for the age group of 18-29 years old and for the female respondents. More than half of the respondents were high in cynicism and those who reported a low professional efficacy (...) were mostly females. Age showed a significant relationship with exhaustion and cynicism while tenure at present job showed a significant relationship with professional efficacy. Results implied that working in a call center may lead to employee burnout especially for females and those who are new in their job. ]]>. (shrink)

Control measures, such as “lockdowns”, have been widely used to suppress the COVID-19 pandemic. Under some conditions, they prevent illness and save lives. But they also exact an economic toll. How should we balance the impact of such policies on individual lives and livelihoods (and other dimensions of concern) to determine which is best? A widely used method of policy evaluation, benefit–cost analysis (BCA), answers these questions by converting all the effects of a policy into monetary equivalents and then (...) summing them up. A different method, social welfare analysis, proceeds by determining the effects of a policy on individual wellbeing and then applying an aggregation formula to them to evaluate the overall effects of a policy. In this chapter, we survey these methods and argue that social welfare analysis has important advantages. One crucial advantage is that it enables ethical considerations relating to the impact of policies on individual wellbeing and its distribution to be incorporated into policy assessments in a transparent way. We illustrate this with a simple numerical model for evaluating pandemic policies that vary in terms of the stringency of the controls that they impose on individual behaviour, showing how the evaluation depends on the ethical significance accorded to their impact on the wellbeing of different age and income groups. (shrink)

This article posits and defends an argument that a cosmopolitan common mind approach is essential for resolving global challenges that cannot be resolved by individuals working independently from one another, such as achieving global peace, cleaning the environment, and improving public health. A ‘cosmopolitan common mind’ refers to an intersubjective recognition across states, cultures, or continents. This argument of the cosmopolitan common mind is centred on Philip Pettit’s theory of the common mind and ethical cosmopolitanism. Pettit argues that a (...) common mind is a shared mind. The standard account of cosmopolitanism claims all human beings are members of the human community. This account is based on three key ideals: individualism, egalitarianism, and universalism. Cosmopolitanism considers individuals rather than nations or states, giving them equal moral status across the world without any discrimination. A cosmopolitan common mind can direct collective action across cultures or continents to resolve global problems. Terrorism and climate change are global problems that are not the products of individual actions but collective actions. For instance, pollution is created by many people working together. If people all together create pollution, they all together can stop it. The problems of establishing global peace and clean ecology are similar to preventing pollution because they are beyond the ability of any lone individual to solve. If it is not impossible, there is a need to develop a cosmopolitan common mind to acquire the common good. The research concludes that the cosmopolitan common mind approach can be a promising framework for resolving contemporary challenges. In qualitative research methodology, I use empirically informed philosophical analysis to critically evaluate documentary resources, including journal papers, academic books, and the proceedings of conferences and congresses. (shrink)

The COVID-19 pandemic revealed numerous weaknesses in pandemic preparedness and response, including underfunding, inadequate surveillance, and inequitable distribution of countermeasures. To overcome these weaknesses for future pandemics, WHO released a zero draft of a pandemic treaty in February, 2023, and subsequently a revised bureau's text in May, 2023. COVID-19 made clear that pandemic prevention, preparedness, and response reflect choices and value judgements. These decisions are therefore not a purely scientific or technical exercise, but are fundamentally grounded (...) in ethics. The latest treaty draft reflects these ethical considerations by including a section entitled Guiding Principles and Approaches. Most of these principles are ethical—they establish core values that undergird the treaty. Unfortunately, the treaty draft's set of principles are numerous, overlapping, and show inadequate coherence and consistency. We propose two improvements to this section of the draft pandemic treaty. First, key guiding ethical principles should be clearer and more precise than they currently are. Second, the link between ethical principles and policy implementation should be clearly established and define boundaries on acceptable interpretation, ensuring that signatories abide by these principles. (shrink)

This Open Access book shows how value sensitive design (VSD), responsible innovation, and comprehensive engineering can guide the rapid development of technological responses to the COVID-19 crisis. Responding to the ethical challenges of data-driven technologies and other tools requires thinking about values in the context of a pandemic as well as in a post-COVID world. Instilling values must be prioritized from the beginning, not only in the emergency response to the pandemic, but in how to proceed with new (...) societal precedents materializing, new norms of health surveillance, and new public health requirements. -/- The contributors with expertise in VSD bridge the gap between ethical acceptability and social acceptance. By addressing ethical acceptability and societal acceptance together, VSD guides COVID-technologies in a way that strengthens their ability to fight the virus, and outlines pathways for the resolution of moral dilemmas. This volume provides diachronic reflections on the crisis response to address long-term moral consequences in light of the post-pandemic future. Both contact-tracing apps and immunity passports must work in a multi-system environment, and will be required to succeed alongside institutions, incentive structures, regulatory bodies, and current legislation. This text appeals to students, researchers and importantly, professionals in the field. (shrink)

The ethical issues raised by cybersecurity practices and technologies are of critical importance. However, there is disagreement about what is the best ethical framework for understanding those issues. In this paper we seek to address this shortcoming through the introduction of a principlist ethical framework for cybersecurity that builds on existing work in adjacent fields of applied ethics, bioethics, and AI ethics. By redeploying the AI4People framework, we develop a domain-relevant specification of five ethical principles in cybersecurity: (...) beneficence, non-maleficence, autonomy, justice, and explicability. We then illustrate the advantages of this principlist framework by examining the ethical issues raised by four common cybersecurity contexts: penetration testing, distributed denial of service attacks (DDoS), ransomware, and system administration. These case analyses demonstrate the utility of this principlist framework as a basis for understanding cybersecurity ethics and for cultivating the ethical expertise and ethical sensitivity of cybersecurity professionals and other stakeholders. (shrink)

Across care settings, the practice of lying to or withholding the truth from people living with dementia is common, yet it is objected to by many. Contrary to this common discomfort, I have argued in previous work that respecting members of this group as moral equals sometimes requires deceiving them. In this paper, I test my proposed practice against complex, controversial cases, demonstrating both its theoretical strength and its practical value for those working in social care.

A familiar part of ordinary moral thought is this idea: when other people are doing something worthwhile together, there is a reason for you to join in on the same terms as them. Morality does not tell you that you must always do this; but it exerts some pressure on you to join in. Suppose we take this idea seriously: just how should it be developed and applied? More particularly, just which groups and which actions are the ones with respect (...) to which you have participatory moral reasons? And just when is it wrong not to join in? I present answers to these questions, and discuss the implications—including for joint action on a very large scale, like global efforts to address climate change or fight a pandemic. (shrink)

Like most bioethical discussion, examination of human biobanks has been largely framed in terms of research subjects’ rights, principally informed consent, with some gestures toward public benefits. However, informed consent is for the competent, rights-bearing individual: focussing on the individual, it thus neglects social, economic and even political matters; focussing on the competent rights-bearer, it does not serve situations where consent is plainly inappropriate (eg, the young child) or where coercion can obviously be justified (the criminal). Using the British experience (...) of large-scale biobanking, I argue that the focus on consenting individuals distorts our ways of thinking about biobanks and has serious practical ramifications. This becomes clear if we contrast the case of adult biobanks intended for medical research with two other forms of biobanking. Thus child cohort studies – vital for sound scientific investigation of the interplay of genetics and environment in health – have been very badly funded next to adult studies. On the other hand, forensic databases have attracted massive investment, but little debate – partly owing to a sense that here, at least, is a case where consent is not relevant. Contrasting these central types of biobanking, I will suggest that there are powerful factors at work in limiting ‘ethics’ to individual rights. Projects of this size should direct our attention to more overtly political questions concerning priority setting and organisation of medical research. (shrink)

This open-access issue aims to highlight views about justice in a pandemic context from Latin American countries and to contribute to the dialogue between them as well as with the global scientific community. It explores the global challenges of the COVID-19 pandemic, relevant differences between public health measures and their impact on high-income countries versus low- or middle-income countries, and how global injustice deepened because of the COVID-19 pandemic. It also draws attention to experiences, outcomes, and responses (...) to the pandemic from the global north regarding vulnerable populations and exposure paths that are also present in Latin America. (shrink)

The study investigated ethical considerations and science diplomacy on coronavirus disease (Covid-19) pandemic in Nigeria. The outbreak of the coronavirus disease (Covid-19) in Nigeria has spread quickly to about 34 states out of the 36 states and over 5000 persons have tested positive as at the time of this research after the first index case of an Italian and there is a projection that in coming days and weeks the number of infected persons and states will increase. The study (...) was guided by two objectives and also adopted the normative ethical theory. The study employed the methods of exposition and critical analysis to explain better the ethical issues and science diplomacy of Covid-19 pandemic in Nigeria. Data was sourced from secondary sources such as journal articles, newspaper, books and internet sources. The findings of the study showed that the citizens have some obligations that will aid the containment of the virus and as well as the government. The study also found out that science diplomacy was used, which has led to Nigeria collaborating with China to get medical aids to effectively fight the pandemic. Consequently, the study recommended amongst others that the Ministry of Health and the Nigeria Center for Disease Control (NCDC) should adopt and enforce the World Health Organization (WHO) Guidance for Managing Ethical Issues in Infectious Disease Outbreak as a working document in crisis like the Covid-19 pandemic that has ravaged Nigeria and the government should involve more in science diplomacy with other countries so that it will help in the fight against Covid-19 and other diseases that may occur in the future. (shrink)

Retirement is often viewed as a reward for a working life. While many have reason to want a work-free retirement, not everyone does. Should working retirees have to give up their retirement pension and, consequently, their status as retirees? The answer, I argue, boils down to whether we conceive of retirement as free time (need-free) or as leisure (work-free). In this article, I put forward a liberal case in favour of free time, despite whether our liberalism leans towards (...) perfectionism or neutralism, with social primary goods being a case in point. Applying this case for free time to retirement yields two significant policy implications. First, it demands “free synchronic combination” – that retirees may use their retirement pensions however they see fit, including to work. Second, it also yields “free diachronic combination” – that, within limits, individuals have discretionary control over how to combine retirement and work across time – thus challenging the idea that retirement should be available only in old age and not earlier in life. So far, the literature on free time focused only on narrow temporal units, such as hours and days, but there is much to gain by extending the concept into retirement. (shrink)

A recent systematic review of Machine Learning (ML) approaches to health data, containing over 100 studies, found that the most investigated problem was mental health (Yin et al., 2019). Relatedly, recent estimates suggest that between 165,000 and 325,000 health and wellness apps are now commercially available, with over 10,000 of those designed specifically for mental health (Carlo et al., 2019). In light of these trends, the present chapter has three aims: (1) provide an informative overview of some of the recent (...) work taking place at the intersection of text mining and mental health so that we can (2) highlight and analyze several pressing ethical issues that are arising in this rapidly growing field and (3) suggest productive directions for how these issues might be better addressed within future interdisciplinary work to ensure the responsible development of text mining approaches in psychology generally, and in mental health fields, specifically. In Section 1, we review some of the recent literature on text-mining and mental health in the contexts of traditional experimental settings, social media, and research involving electronic health records. Then, in Section 2, we introduce and discuss ethical concerns that arise before, during, and after research is conducted. Finally, in Section 3, we offer several suggestions about how ethical oversight of text-mining research might be improved to be more responsive to the concerns mapped out in Section 2. (shrink)

-/- Did the US president who signed the order to use the atomic bomb stain his hands with blood or just ink? Are there cases in which a war is just? In such cases, is any war justifiable? Is ending the life of a terminally ill person different from murder? Do we need to agree on the definition of the embryo as a 'person' to know whether any action on the embryo is prohibited? Is the prohibition of contraception justified even (...) if it is perfectly legitimate to plan births? Anscombe, taking up Wittgenstein, Aristotle and Thomas Aquinas, elaborates a theory of action that places "intention" at the centre, an alternative to the conception of action dominant since Descartes. On this basis, he conducts an indictment against the superficiality of modern moral philosophy, lumping together the Oxford philosophers, utilitarianism and Kantian ethics. And finally, she puts her virtue ethics to work on problems of applied ethics: in the field of public ethics, the just war; in the field of bioethics, questions of the end of life and the beginning of life. This book, edited by Sergio Cremaschi, brings together Anscombe's contributions on ethical issues, allowing for the first time a comprehensive overview of this decisive figure's contribution to twentieth-century philosophy. (shrink)

This dissertation explores the idea and ethics of vaccination for the sake of others. It conceptually distinguishes four different kinds of vaccination—self-protective, paternalistic, altruistic, and indirect—based on who receives the primary benefits of vaccination and who ultimately makes the vaccination decision. It describes the results of focus group studies that were conducted to investigate what people who might get vaccinated altruistically think of this idea. It also applies the different kinds of vaccination to ethical issues surrounding COVID-19, such (...) as lockdown measures, routine or mandatory vaccination of healthy children, and the ethical justification of restrictive measures for unvaccinated people. A more general philosophical account of vaccination ethics is ultimately developed, which is based not on moral duties, but on the moral reasons that people may have to get vaccinated for the sake of others. It is argued that such reasons may be stronger or weaker, depending on various factors related to the vaccines in question and the specific epidemiological circumstances. (shrink)

In the past decade UNESCO has pursued a leadership role in the articulation of general principles for bioethics, as well as an extensive campaign to promulgate these principles globally.1 Since UNESCO's General Conference adopted the Universal Declaration on Bioethics and Human Rights in 2005, UNESCO's Bioethics Section has worked with member states to develop a "bioethics infrastructure." UNESCO also provides an "Ethics Teacher Training Course" to member states and disseminates a "core curriculum," primarily targeting medical (...) students. The core curriculum orients itself by the Universal Declaration on Bioethics and Human Rights and aims to articulate a set of "bioethical principles" that provide a "common global . (shrink)

Animal ethics has reached a new phase with the development of animal ethical thinking. Topics and problems previously discussed in terms of moral theories and ethical concepts are now being reformulated in terms of political theory and political action. This constitutes a paradigm shift for Animal Ethics. It indicates the transition from a field focused on relations between individuals (humans and animals) to a new viewpoint that incorporates the political dimensions of the relationships between human communities and non-human (...) animals. Animals are no longer seen as a heterogeneous group of sentient beings or simply as species, but as part of a common good that is simultaneously human and animal. In order to participate in this new phase, bioethics will have to face a series of challenges that have hindered the integration of animal ethics within its field. It will also need the development of a new theoretical framework based on relations between communities of individuals. This framework will be able to highlight the ethical and political dimensions that arise from interactions between human communities, non-human animals and the ecosystem. (shrink)

The declaration of the COVID-19 pandemic by the World Health Organization on March 11, 2020, led to unprecedented events. All regions of the world participated in implementing preventive health measures such as physical distancing, travel restrictions, self-isolation, quarantines, and facility closures. The pandemic started global disruption of socio-economic systems, covering the postponement or cancellation of public events, supply shortages, schools and universities’ closure, evacuation of foreign citizens, a rise in unemployment and inflation, misinformation, the anti-vaccine movement, and incidents (...) of discrimination toward people affected by or suspected of having coronavirus disease. Attempts have been made to protect the oldest age group at risk, but in many cases, this has led to over-restriction and age discrimination. The rationale for working on the Research Topic "Socio-economic systems in the post-pandemic world: Design thinking, strategic planning, management, and public policy" was the need to start reflecting on resilience and lessons learned from this public health event that revealed the global unpreparedness in critical areas. Also, the pandemic triggered both top-down and bottom-up responses that needed more in-depth analyzes. This Research Topic covers interdisciplinary contributions addressing new thinking, challenges, and transformations required for post-pandemic global, national, regional, and local realities. The presented Research Topic combines studies focused on recognizing the actions and interventions leading to the recovery of socio-economic systems during the tail end and after the pandemic. The studies delivered recommendations regarding, among others, the care of vulnerable, planning socio-economic restart, and imagining the "new normal.". (shrink)

That technologies may raise ethical issues is now widely recognised. The ‘responsible innovation’ literature – as well as, to a lesser extent, the applied ethics and bioethics literature – has responded to the need for ethical reflection on technologies by developing a number of tools and approaches to facilitate such reflection. Some of these instruments consist of lists of questions that people are encouraged to ask about technologies – a methodology known as the ‘Socratic approach’. However, to date, (...) these instruments have often not adequately acknowledged various political impacts of technologies, which are, I suggest, essential to a proper account of the ethical issues they raise. New technologies can make some people richer and some people poorer, empower some and disempower others, have dramatic implications for relationships between different social groups and impact on social understandings and experiences that are central to the lives, and narratives, of denizens of technological societies. The distinctive contribution of this paper, then, is to offer a revised and updated version of the Socratic approach that highlights the political, as well as the more traditionally ethical, issues raised by the development of new technologies. (shrink)

Resumen Ésta es la primera traducción al español de las guías “Atención después de la investigación: un marco para los comités de ética de investigación del National Health Service (NHS) (borrador versión 8.0)”. El documento afirma que existe una fuerte obligación moral de garantizar que los participantes enfermos de un estudio clínico hagan una transición después del estudio hacia una atención de la salud apropiada. Con “atención de la salud apropiada” se hace referencia al acceso para los participantes a la (...) atención de la salud, proporcionada principalmente por el National Health Service (en adelante NHS), el sistema de salud del Reino Unido, y/o a la intervención en estudio, también llamada producto o tratamiento en investigación. Las guías “Atención después de la investigación” están dirigidas principalmente a los miembros de los 79 comités de ética de investigación del NHS y a quienes presentan sus estudios de investigación ante estos comités. Se trata de un documento borrador muy avanzado, trabajado en numerosas reuniones, durante más de 3 años, que ha sido discutido por participantes de estudios y miembros de la comunidad, miembros y presidentes de comités de ética de investigación del Reino Unido, especialistas internacionales en ética de la investigación, representantes de la industria y otras partes interesadas. La redacción de las guías es producto de la colaboración de Neema Sofaer y Penney Lewis, ambas investigadoras del King’s College London, en el Centre of Medical Law and Ethics del Dickson Poon School of Law, y Hugh Davies, Asesor en Ética de la Investigación de la Health Research Authority (HRA) del NHS. El traductor del presente documento, Ignacio Mastroleo, participó del workshop en la Fundación Brocher (Ginebra, Suiza, diciembre de 2011) donde se revisó el borrador versión 7.0 y contribuyó en la revisión del borrador de la versión 8.0 durante el 2012. -/- Abstract This is the first Spanish translation of the guidelines “Care after research: a framework for NHS RECs (8th draft)”. The document states that there is a strong moral obligation to ensure that participants in a clinical study who are ill transition after the study to appropriate healthcare. The terms "appropriate healthcare" refer to participants’ access to health care, mainly provided by the National Health Service (NHS), the health system in the UK, and/or to the intervention study also named investigational treatment or product. The guides "Care after research" are mainly directed to members of the 79 NHS committees of research ethics (RECs) and to those who submit their research to these committees. This is a very advanced draft document, worked in several meetings, for more than three years, that has been discussed with study participants and community members, members and chairs of RECs in the UK, international specialists in research ethics, industry representatives and other stakeholders. The drafting of the guidelines is the result of the collaboration of Neema Sofaer and Penney Lewis, both researchers at King's College London, at the Centre of Medical Law and Ethics of Dickson Poon School of Law, and Hugh Davies, Research Ethics Advisor of the Health Research Authority (HRA) of the NHS. The translator of this document, Ignacio Mastroleo, attended the workshop at the Brocher Foundation (Geneva, Switzerland, December 2011) where draft version 7.0 was revised and contributed in the revision of draft version 8.0 during 2012. (shrink)

As COVID-19 spread, clinicians warned of mental illness epidemics within the coronavirus pandemic. Funding for digital mental health is surging and researchers are calling for widespread adoption to address the mental health sequalae of COVID-19. -/- We consider whether these technologies improve mental health outcomes and whether they exacerbate existing health inequalities laid bare by the pandemic. We argue the evidence for efficacy is weak and the likelihood of increasing inequalities is high. -/- First, we review recent trends (...) in digital mental health. Next, we turn to the clinical literature to show that many technologies proposed as a response to COVID-19 are unlikely to improve outcomes. Then, we argue that even evidence-based technologies run the risk of increasing health disparities. We conclude by suggesting that policymakers should not allocate limited resources to the development of many digital mental health tools and should focus instead on evidence-based solutions to address mental health inequalities. (shrink)

This paper aims to analyze the ethical challenges in experimental drug use during the early stage of the COVID-19 pandemic, using Germany as a case study. In Germany uniform ethical guidelines were available early on nationwide, which was considered as desirable by other states to reduce uncertainties and convey a message of unity. The purpose of this ethical analysis is to assist the preparation of future guidelines on the use of medicines during public health emergencies. The use of hydroxychloroquine, (...) remdesivir and COVID-19 convalescent plasma in clinical settings was analyzed from the perspective of the ethical principles of beneficence, non-maleficence, justice and autonomy. We observed that drug safety and drug distribution during the pandemic affects all four ethical principles. We therefore recommend to establish ethical guidelines (i) to discuss experimental treatment options with patients from all population groups who are in urgent need, (ii) to facilitate the recording of patient reactions to drugs in off-label use, (iii) to expand inclusion criteria for clinical studies to avoid missing potentially negative effects on excluded groups, and (iv) to maintain sufficient access to repurposed drugs for patients with prior conditions. (shrink)

We expand on Della Croce’s ambition to interpret “epistemic injustice” as a specification of non-maleficence in the use of the influential four-principle framework. This is an alluring line of thought for conceptual, moral, and heuristic reasons. Although it is commendable, Della Croce’s attempt remains tentative. So does our critique of it. Yet, we take on the challenge to critically address two interrelated points. First, we broaden the analysis to include deliberations about hermeneutical injustice. We argue that, if due consideration of (...) epistemic injustice is to require more than negative ethical obligations in medicine, dimensions of hermeneutical injustice should be explored as an avenue to arrive at such positive duties. Second, and relatedly, we argue that this may encompass moral responsibilities beyond the individual level, that is: positive obligations to take action on a structural level. Building on Dotson’s concept of “contributory injustice” and Scheman’s concept of “perceptual autonomy,” we suggest that the virtues of testimonial and hermeneutical justice may provide additional content not only to negative prohibitions of action (i.e. non-maleficence) but also to positive requirements of action, like respecting patient autonomy. (shrink)

Two Members of BBS awarded Erasmus Mundus Master of Bioethics -/- Shamima Parvin Lasker, Professor and Head, Department of Anatomy, City Dental College, Dhaka & General Secretary of BBS and Dr Abu Sadat Mohammad Nurunnabi, Lecturer of Anatomy, Dhaka Medical College, Dhaka & Life member of BBS awarded Master of Bioethics in 2012. Both they are the scholars of Erasmus Mundus Master of Bioethics. Degree was awarded by K.U.Leuven, Belgium, Radboud Universiteit Nijmegen, Netherlands and Università degli Studi (...) di Padova, Italy. -/- Prof Shamima’s research was on “Attitudes Toward Surrogacy Around Muslim World” under supervision of Dr Marcello Ghilardi, University of padova , Italy whereas Dr Nurunnabi worked on Prospects and Problems of Stem Cell Research in Bangladesh: Can Equity and Justice be Maintained in Context of Public Health Demand? under supervision of Professor Evert van leeuwen, Chair of the Section Ethics, IQ healthcare, Philosophy and History of Medicine, Radboud University, Nijmegen Medical Centre, Netherlands. -/- Thanks and congratulations for them and for their outstanding achievements on behalf of all the Members of the Bangladesh Bioethics Society. -/- . (shrink)